Gadolinium-Associated Nephrogenic Systemic Fibrosis

摘要

[...] the risk of nephrogenic systemic fibrosis can be reduced by judicious use of these scans. The FDA does not make distinctions of which type of gadolinium to avoid, but recognizes that the highest reported agent has been gadodiamide (Omniscan).7 The ESUR guideline on nephrogenic systemic fibrosis specifically discusses the different types of gadolinium contrast media, recommending against using gadodiamide, gadopentetate dimeglumine (Magnevist), and gadoversetamide (Optimark) in patients with stage 4 or 5 chronic kidney disease and those patients with reduced renal function who are awaiting liver transplantation.15 Screening all patients for renal dysfunction by obtaining a history or ordering laboratory testing for GFR calculation is also recommended.7 The ESUR guideline further recommends caution in patients with stage 3 chronic kidney disease (GFR less than 60 mL per minute per 1.73 m2), pregnant women, and children younger than one year.15 Final Comment Nephrogenic systemic fibrosis is an important disease of which all physicians who order MRI with gadolinium- based contrast agents must be aware.